Marley Oaks Assisted Living Residence

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARLEY OAKS ASSISTED LIVING RESIDENCE

Practice address

12631 187TH St
Mokena, IL 60448-8731

Phone

(815) 485-5860

NPI assigned

Apr 10, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. James Charles Stellwagen

Title

Treasurer

Phone

(815) 685-5803

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1083233076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 187TH ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488731",
            "telephone_number": "815-485-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12631 187TH ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488731",
            "telephone_number": "815-485-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLEY OAKS ASSISTED LIVING RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "STELLWAGEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "815-685-5803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Mannix, LCSW
• Haytham Mansour, D.P.M.
• Manuel Perez, M.D.,S.C.
• Sheila Marie Mara, FNP
• Kara Marcus, MS CCC-SLP
• Marquette Eye and Vision Center, LLC
• Robert William Marquis, M.D.
• Laura Ann Martin, FNP
• Michele Marie Martin, APRN
• Patricia Martin, M S CCC SLP L

• Assisted Living Facility in Mokena, IL
• Providers in Mokena, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.